San Pedro Town Council FoodBank Program

This new program will allow qualified families to purchase a Food Bag for the sum of BZ$25.00 per bag. The program aim is for the Food Bag to have a retail value of BZ$40.00 and up. The money saved with this program can then be used on other expenses.

The Assistance Program is based on financial need. To qualify Applicants must provide evidence of financial need. The ultimate decision will be made by the Financial Aid Committee.

Note: Applicants who receive substantial financial aid from another source may have their application denied by the Financial Aid Committee after submission.

Application Process:

Individuals interested in applying for the Low Cost Food Program are to complete the application form below.

Name *

First Name Last Name

Birthdate *

Date

Social Security Number *

Phone Number *

Email *

example@example.com

Home Address *

Street Address

Street Address Line 2

Marital Status *

Spouse/ Partner Name

First Name Last Name

Spouse Birthdate

Date

Spouse Phone Number

Does any family member have any disabilities? *

No Yes

If Yes give details of disabilities

Is any family member pregnant? *

Yes No

How many dependents (persons under 21, over 65 or with a disability) live with you? *

How many of these dependents are attending school?

	Number
Primary School
High School
College

Do you OWN or RENT your home? *

EXPENSES: VERIFICATION OF ALL INCOME/ EXPENSES IS REQUIRED

	AVERAGE AMOUNT PER MONTH $
RENT/ MORTGAGE
ELECTRICTY
WATER
FOOD/ GROCERIES
OTHER

EMPLOYMENT/VERIFICATION OF ALL INCOME/ EXPENSES IS REQUIRED


OCCUPATION
EMPLOYER
INCOME (indicate monthly)

If you are NOT working, why not? Please explain:

Do you receive MAINTENANCE income for any of your children? *

No Yes If Yes, give amount

Are you receiving assistance from any other source? If yes, please explain:

SPOUSE/ PARTNER EMPLOYMENT/INCOME: VERIFICATION OF ALL INCOME/ EXPENSES IS REQUIRED


OCCUPATION
EMPLOYER
INCOME (indicate monthly)

If he/she is NOT working, why not? Please explain:

Please explain how you have been impacted by COVID-19 and how this program would benefit you: *

Date *

Date

Signature *

Clear

More Information:

Contact Councillor Dianeli 'Danni' Aranda - 673-2199.

Women, Youths and Children Affairs Office inside Island Galleria Building, Corner Coconut Drive & Tarpon Street, San Pedro Town, Ambergris Caye, Belize.

Monday to Friday: 10am to 12pm and 1:30pm to 4pm.

Application for San Pedro Town Council - LOW COST FOOD PROGRAM